Rheumatology International

, Volume 25, Issue 3, pp 215–219 | Cite as

Proposal for a sonographic classification of target joints in rheumatoid arthritis

  • Klaus LerchEmail author
  • Nicola Borisch
  • Christian Paetzel
  • Joachim Grifka
  • Wolfgang Hartung
Original Article



The purpose of this study was to classify sonographically the joint damage of target joints in patients with rheumatoid arthritis (RA).


During a 3-year cross-sectional study, standardized arthrosonography of symptomatic target joints was performed in patients with RA. According to those findings, a classification with progressive deterioration of joint alteration in RA was created that grades visible morphological changes of the joint components. Using elbow joints as a subgroup, inter- and intraobserver reliability was calculated.


Examined and included in this study were 1211 joints of 425 patients with RA. The mean disease activity score was 5.2 (range 0.75–7.79). Sonographically visible changes could be classified and divided into six stages. A standardized sonographic evaluation system was developed. In reference to the elbow joint, overall percentages for intra- and interobserver reliability of sonography were 90.8% and 88.8%, respectively.


Sonography is a valuable tool for assessing and classifying joint alteration in RA. Particularly in early stages of joint affection, ultrasound is superior to X-ray in detecting soft tissue changes and minor erosions.


Classification Diagnostic criteria Rheumatoid arthritis Sonography Ultrasound 


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Copyright information

© Springer-Verlag 2003

Authors and Affiliations

  • Klaus Lerch
    • 1
    Email author
  • Nicola Borisch
    • 1
  • Christian Paetzel
    • 2
  • Joachim Grifka
    • 1
  • Wolfgang Hartung
    • 3
  1. 1.Department of Orthopedic SurgeryUniversity of RegensburgBad AbbachGermany
  2. 2.Department of RadiologyUniversity of RegensburgRegensburgGermany
  3. 3.Department of Rheumatology, Division of Internal MedicineBavarian Rheumatologic and Orthopedic CenterBad AbbachGermany

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